Stan A. Huber Consultants, Inc. 
Health Physics & Radiation Safety Services 

Leak Test Order Form

Please complete all sections of this form and submit it to SAHCI by pushing  the SUBMIT button at the bottom of the form.  We will immediately mail you the number of leak test kits you requested.


Number of Leak Test Kits Needed                                 x $25 each
The cost per kit includes 1st class postage, analysis and certificate emailed to you.

Payment Information

Name on Card

Credit Card Number

Expiration Date (mm/yyyy)                        3 Digit Security Code            

Zip Code for Card Holder

Charge my Credit Card
Please Invoice. My purchase order number is